The causes of visual impairment in children in a school for the blind in Johannesburg - a cross sectional study
No Thumbnail Available
Date
2019
Authors
Esra, Nira Yael
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Background: More than 1.4 million children are blind throughout the world. This is of
significance due to the social, emotional and economic implications of childhood visual
impairment, which are endured throughout a life time of “blind years”. Information regarding
the epidemiology and risk factors relating to childhood visual impairment is essential for the
development and implementation of targeted interventions, in order to reduce childhood
blindness.
Objectives: To identify the causes of childhood blindness in a school for the blind in
Johannesburg, South Africa, as a representation of trends in our urban population, and to
compare these findings with those of a similar study conducted in 1996, in order to inform
health policy decision making.
Methods: All learners attending a school for the blind in Johannesburg were evaluated.
Information obtained was recorded using the World Health Organisation’s Programme for the
Prevention of Blindness (WHO/ PBL) method and reporting form.
Results: One hundred and eighty nine learners were examined, of which, 110 (58%) had
severe visual impairment or blindness. The major affected anatomical sites were the
retina (43%), whole globe (16%), optic nerve (10%), cornea (10%), uvea (6%) and lens
related conditions (4%). Retinopathy of prematurity was the most common retinal
condition (n=26, 14%). This has increased 11 fold (p<0.005) when compared to the
findings in 1996. Hereditary and neonatal factors were responsible for visual impairment
in 28% and 14% of learners respectively. Aetiology was indeterminate in 45% of
learners. Avoidable causes accounted for 29% of learners with visual impairment which
was significantly lower than findings from the previous study (p=0.016).
Conclusion: There has been a substantial change in the disease pattern of childhood
blindness, in this study population, compared to the findings of the previous study. While
many advances have been made regarding immunisation, vitamin supplementation and
ophthalmic management, the implementation of further measures are still required in
order to overcome preventable causes of childhood visual impairment.
Description
A dissertation submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree
of Master of Medicine
Johannesburg 2019